Researchers From University Of Zurich Issue Warning That New Migraine Medications Could Kill Patients With High Blood Pressure
Source: Thailand Medical news Nov 27, 2019 5 years, 4 weeks, 6 hours, 23 minutes ago
Medical researchers from University of Zurich are warning that a new class of
migraine medications that work by blocking αCGRP, a neuropeptide which causes vasodilation, for example in the meninges could endanger the lives of those with
high blood pressure.
The very same neuropeptide, αCGRP which is formed in the muscles during physical activity, protects the heart is extremely vital for people with chronic
high blood pressure.
The innovative
migraine prophylaxis could endanger these people, as researchers at the University of Zurich have demonstrated in mice.
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This neuropeptide αCGRP (α calcitonin gene-related peptide) works in two different ways. It leads to inflammation and dilates the blood vessels right at the release point of the nerve cells, for example in the meninges, which can trigger
migraine attacks.
However, it has a completely different effect on the heart, as has now been discovered by a team of researchers at the University of Zurich (UZH)
The scientists demonstrated through studies on mice, αCGRP is also released from active skeletal muscles. It is transported via the blood from the muscle to the heart where it inhibits the pathological heart remodeling caused by chronic
high blood pressure.
Dr Johannes Vogel, professor at the UZH Institute of Veterinary Physiology and study leader told
Thailand Medical News, "It is exactly the same for humans as it is for mice.Physical activity and sport increase the blood plasma levels of αCGRP, which has a positive effect on the heart in patients with h
igh blood pressure."
The research carried out by the researchers involved comparing normal mice with others having chronic
high blood pressure, which were either sedentary or repeatedly and voluntarily ran in a running wheel.
The research revealed that having normal concentrations of αCGRP in the blood plasma is vital and that the peptide is crucial for the positive effects of physical activity on the heart. αCGRP also provides the heart with extra protection, regardless of its antihypertensive properties in high doses.
"In the future, substances that activate the release of αCGRP or mimic its action could be used in hypertensive patients who can only be physically active to a very limited extent or in whom antihypertensive medications have little or no effect," explains Dr Johannes Vogel.
The research work also brought another finding to light long-term administration of αCGRP blockers in mice with chronic high blood pressure resulted in life-threatening cardiac dysfunction.
Migraine medications of this kind, which take a targeted approach to blocking the neuropeptide, have recently be
en approved for
migraine prophylaxis. As the neuropeptide αCGRP in species from zebrafish to humans is very similar, it must be part of a key biological mechanism that works in the same way in different organisms.
Cardiovascular specialist Dr Vogel warns, the results are therefore also relevant to humans: "αCGRP blockers should only be used for
migraine prevention with the proviso that patients' blood pressure is monitored regularly. Chronic high blood pressure should be added to the list of contraindications for the long-term use of αCGRP blockers."
The team is also presenting its study results to various drug regulatory bodies worldwide for box warnings and label warning inclusions.
Reference : Tom Skaria et al. Blood Pressure Normalization-Independent Cardioprotective Effects of Endogenous, Physical Activity-Induced Alpha Calcitonin Gene-Related Peptide (αCGRP) in Chronically Hypertensive Mice, Circulation Research (2019). DOI: 10.1161/CIRCRESAHA.119.315429
Note: These are the current class of migraine medications that use αCGRP inhibitors:
Ajovy ,Generic name: fremanezumab ,
Aimovig ,Generic name: erenumab
Emgality, Generic name: galcanezumab
Eptinezumab (pending approval)
